Levitt B, Keefe D L
J Clin Pharmacol. 1985 Oct;25(7):507-13. doi: 10.1177/009127008502500706.
Digitalis is a drug widely used in modern medicine for the control of ventricular response in atrial fibrillation and the treatment of congestive heart failure (CHF). Recently, the use of digitalis for the treatment of CHF in patients in sinus rhythm has become quite controversial. The findings of several clinical studies suggest a small but definite hemodynamic or clinical improvement in patients treated with digitalis. These effects are limited by the onset of toxicity, which is at least partially mediated via the central nervous system. If the inotropic effect of the drug could be separated from the central nervous system effect, much higher doses of digitalis could be tolerated and presumably a greater therapeutic effect could be obtained.
洋地黄是现代医学中广泛用于控制心房颤动时心室反应及治疗充血性心力衰竭(CHF)的一种药物。最近,洋地黄用于治疗窦性心律患者的CHF已颇具争议。多项临床研究结果表明,接受洋地黄治疗的患者有轻微但确切的血流动力学或临床改善。这些作用受毒性发作的限制,毒性发作至少部分是通过中枢神经系统介导的。如果该药物的正性肌力作用能与中枢神经系统作用分离,那么就可以耐受更高剂量的洋地黄,并且可能会获得更大的治疗效果。